Bringing South African Men into HIV Counseling and Testing (HCT) and Care

 描述(由申请人提供)：这项研究的最终目标是提供循证战略，以改善艾滋病毒+男性的治疗。治疗即预防(TasP)只能通过三个步骤发挥作用：(1)检测相当大比例的人群，(2)与护理挂钩，(3)将相当大比例的艾滋病毒感染者保持在护理中，使其达到病毒抑制点。增加检测、与男性的联系和维护男性护理的好处将是巨大的。我们提出了一项研究，将结构性和个人层面的干预措施结合起来，并整合了结果，以解决我们的总体目标，即在护理中保持对病毒的抑制。目的1：在一项整群随机研究中，我们将调查以男性为中心的动员和检测是否会使(在过去12个月内)接受检测的男性的人口水平百分比增加超过10个绝对百分点。目的2：在个人随机设计中，我们将调查POC CD4检测和个体化病例管理是否改善了单独POC CD4检测和护理标准与护理(确诊后立即)和病毒抑制(12个月后)之间的联系。目的3：综合两个试验部分(目标1和目标2)的结果，以评估干预措施对艾滋病毒阳性男性有效检测、与护理有关并患有无法检测到的VL的百分比的联合影响。增加检测、与男性的联系和维护男性护理的好处将是巨大的。男性将更健康，可以工作和养家糊口，有助于而不是消耗家庭经济资源，抚养孩子，他们将不太可能将艾滋病毒传播给女性伴侣。

 DESCRIPTION (provided by applicant): The ultimate objective of this research is to provide evidence-based strategies to improve treatment of HIV+ men. Treatment as prevention (TasP) can only work through a three step process: (1) Testing a significant proportion of the population, (2) linkage to care and (3) maintaining in care a significant proportion of HIV+ individuals to the point of viral suppression. The benefits of increased testing, linkage to and maintenance in care for men would be enormous. We propose a study that combines structural and individual level interventions and integrates the results to address our overall objective of maintenance in care to the point of viral suppression. Aim 1: In a cluster-randomized study, we will investigate whether male-centered mobilization and testing increases the population-level percentage of men who have been tested (within the last 12 months) by more than 10 absolute percentage points. Aim 2: In the individually-randomized design, we will investigate whether POC CD4 testing and individualized case management improves linkage to care (immediately following diagnosis) and viral suppression (12 months later) over POC CD4 testing alone and standard of care. Aim 3: Integrate the results of the two trial components (Aims 1 and 2) to evaluate the joint effect of the interventions on the percentage of HIV+ men who are effectively tested, linked to care and maintained with undetectable VL. The benefits of increased testing, linkage to and maintenance in care for men would be enormous. Men would remain healthier longer, could work and support their families, contribute to rather than deplete household economic resources, raise their children, and they would be less likely to transmit HIV to female partners